Cancer Treatment Research

it's a new year. time to quit old habits and develophealthy new ones. sounds great, right? we're so glad you joined us because today's theday you find the strength and the tools to finally quit smoking for good. but as you'vealready heard and probably already know it's easier said than done, especially with a habitas difficult as smoking. i've been smoking for about 40 to 50 years,close to that. i did start smoking probably when i was inmy late teens. i never smoked a lot, but definitely even a little bit is too much.i started from peer pressure actually, and i'm not going to throw any of my friends underthe bus because they were all great friends.

they were like, "come on, eli, have a cigarette."and eventually i was like, "okay. one couldn't hurt." and here i am almost 4 years later.one can hurt. probably around the age of 15 or 16-years-old,i picked one up and it kind of went from there. why is it so hard to quit something that isso dangerous? the answer is not so simple. access health special correspondent, soniavelazquez, is on location with the story. today, i'm meeting with tobacco cessationspecialist, rosemary dunbar, from the iquit program here in south florida. why is tobaccoso difficult to quit? there are two parts to tobacco. one is tar,and that's the gooey substance that makes us sick. it gives us cancer, heart disease,stroke, etc. and nicotine is a drug and it

tells us that we feel good.nicotine is one of the hardest habits to kick. nicotine causes the brain to release neurotransmittersthat cause a pleasurable effect inside the body. when your body stops getting the nicotine,you lose those pleasurable effects, you become irascible, you have anxiety, you become irritable,you become cranky. it is difficult to function without it. you are addicted to it.in my eyes, there's not a difference between smoking 10 cigarettes a day and 30 cigarettesa day. you've got to stop. my wife was really after me to stop, and quitehonestly i've told her so many times that i did stop but i never really did. and i justgot tired of not telling her the truth. my mom would tell me frequently that she hatedthat i smoked, and that hurt really bad because

i hate disappointing my parents.i quit because i want to live a better longer life.say you need to go fly somewhere. so you're thinking about, "i've got to have like 5 cigarettesbefore i get on the plane." you know, that's insane.christmas is coming up. i don't have to worry about going outside to smoke a cigarette andmissing my 7-year-old niece opening her christmas present that i got her.i'd keep some cologne in the car that i would spray myself with so it would cover up thesmell. coming up, our smokers get a little help fromthe community and habitrol. (music). access health.(music).

even with the sobering statistics and theinformation about the harmful effects of tobacco on the body, 18 out of 100 people in the unitedstates are still smoking. the good news is that there is help available to everyone dueto a nationwide effort to reduce the number of tobacco related diseases and deaths. manystates, right now, have funding in place to implement smoking cessation classes that arefree for everyone. all you need to do is bring a desire to quit.we are a state funded program through the department of health, and all of our servicesare completely free to the citizens of florida. we got involved in tobacco cessation actuallyas part of florida's, the state-wide, tobacco free florida initiative through the area healtheducation centers. we do live tobacco cessation

classes, small-group classes throughout thestate in most of the communities in florida. so, i ended up going to the class and oncei got in there, i realized it was more for myself and my health and the freedom. there'sso much freedom when you stop smoking, and i'm saving $150 a month at least.it was highly suggested that i go to this class. so i figured i'd give it a chance.i went to the class and got serious. and it worked.the class taught me a lot of ways to handle different side effects like if i got dehydratedor if i got tired and cranky and hungry, those would usually be big triggers to start smokingagain. it's a 6-week program, and the first two weekswe get people ready. we get them to feel secure,

and start looking at their behaviors. whendid they smoke? there's as much the addiction of the holdingthe cigarette as there is to anything else. so by physically still having that alignmentof holding something and doing something with your hands, holding celery or holding carrotsinstead of smoking, it can help to reduce the cravings.once i got in my car, that was a safe place. that's where i would light up my cigarette.that was the hardest part for me was getting in my car and not lighting up a cigarette.if you find that your trigger is that you like to smoke first thing in the morning,don't smoke first thing in the morning. get up and go for a walk. take the dog for a walk.and it's behavior modification.

my two triggers were getting in my car andmy little garden, my patio. and so i just decided that those were the two places thati was going to stop smoking. the best and more important thing to do isreally set your date and prepare for your quit date.you have to be really gentle with yourself. i know i did, and that's what i recommendto people is just be a little gentle with yourself because you're going to do it. youare going to do it. when i did the class, they gave me a quit date. okay. i didn't quiton that date. but i quit exactly one week later, and i have not smoked since.knowing that i had a time frame and setting a date that was to be my last cigarette, iwas able to live up to that agreement that

i made with myself.i believe it had a lot to do with the preparation ahead of time to get to that point. it's adecision that i'm able to stick with and it's going to enhance my life. i'm not giving anythingup. i'm gaining a whole new life expectancy actually.sometimes they think, "oh, i have to be ready. i have to really be ready." no. give it ashot. try. even if you're just thinking about it, come to the program, we'll work on gettingyou ready. the whole point of quitting smoking is toremove the nicotine from your body. so make it a challenge to reduce the number of cigarettes.when you're removing a drug from your body -- any drug -- nicotine, you have withdrawalsymptoms, and they're unpleasant. by removing

the tar, the thing that makes you sick, andjust giving you the nicotine, the thing that tells your brain you're okay, you can weanyourself slowly off the drug and those withdrawal symptoms are much less.ahec also provides students with complimentary nicotine replacement therapies such as gum,lozenges, and patches. what's nice about the class that i attended,it's wonderful, they give you a choice of the lozenge, the gum, and the patch.based on the number of cigarettes you smoke, you can check the back of the panel or youcan go to the habitrol website, www.habitrol.com, and there are resources there to help youquit. the patch did work for me in combination withlozenges because you would still get that

hand-to-mouth kind of coordination/habit andyou need something to quell that. i would usually rely on gum, but when i didn't haveenough nicotine in my system, the lozenge was a very smoke-free and effective way toquell that craving. using the nicotine patch will help you toreduce the cravings. by having the steady stream of nicotine in your body, you're notcraving that, you're not going out of your way to find it. it doesn't stop you from doingthe activities that you're doing on a day-to-day basis.it was a major thing having the patch for the cravings because i did not have that partof the craving at all anymore. once i put the patch on, it did what it was supposedto do.

studies have shown that the use of a supportprogram lead to much higher success rates when you're quitting smoking.right now, our success rate is about 35% - 36% at the 7-month point which is very good. we'revery happy and proud of that number. it needs to be a partnership, you need somehelp. you know, you may need some help. i mean, how many times do we make a new yearsresolution and then it's gone. you need the help. you need the camaraderie. you need justto be apart of that. i needed the support, and it's only 6 weeks. just do it.it's really important to have a strong support system that you can fall back on because discipleis really really difficult and motivation is fleeting. and when the time comes whenyour discipline or motivation fails you, you're

going to need someone else to help and pickup that slack. and if you have that, it's a lot easier.a facilitator can only do so much. but when you have your peers cheering each other, literallythat's what it is. you listen to one another, you share your stories, what was difficulteach week, what was successful. people learn from each other. what worked for one may helpanother person. and at the end, it's a group celebration.it's been a little over 10 months now since i've had a cigarette. so it's good.i've been smoke free for 5 weeks. i actually don't really think about smoking very muchat all anymore. i sometimes am shocked that i don't smoke.i don't even want to. it's the freedom. it's

the money.get the tools you need, get ready to quit. you, too can succeed.one of the best parts of doing this is hearing from folks that have participated in our programsand have been successful in their quit attempts and the difference that's it made in theirlives and the quality of their lives and everything. so that really is, for me anyway and i thinkfor a lot of people who are involved in this, one of the best parts of all of it.very inspiring. thank you to our guests for all that you're doing to help people kickthe habit for good. now if you'd like to try the habitrol patch, just logon to habitrol.com.and, of course, you can also logon to access health right now for more great information.(music). access health.

(music).for the millions of people suffering from cancer, the diagnosis is often made worseby a type of severe pain. it's a pain so severe that even the strongest narcotics are no match,and very little help was available until now. thinking about when you experience pain totry and remember it is hard, but at the time that i'm experiencing it, it's the most debilitatingfeeling in the world and i start to panic. i can't cope when it starts to happen to mebecause of the fear of not being able to tolerate it. and that scares me.my name is gina adams and in 2010 i was diagnosed with stage 3 colon cancer. i have two daughters,a freshman in college and a senior in college, and i've been married for 23 years to daniel,my husband.

so when my mom's in pain, it's especiallyhard for her to even just like leave her bed or go out of her room or do anything but tryto feel better. she hasn't been absent, but you know sometimes she can't attend things.it's hard to leave the house when you think, you know, you might have a pain episode andyou're going to need to plan for that. she's very involved in my life and my sister's life.but, you know, you can tell that it's harder for her to be there in general.breakthrough cancer pain affects about 60% of all chronic cancer pain patients. the terminologyis self-explanatory. what's more difficult to put into words is just how painful breakthroughcancer pain really is. the pain would come on very very suddenly,and i think the biggest thing about the pain

was the anxiety that went along with it becausewhen i was starting to feel the pain episode come on, the anxiety of me not knowing ifi was going to be able to get through it was debilitating and it would add to the wholething. i would start getting clammy and start getting, you know, just very anxious and wonderinghow i was going to get through everything. joining me now is hematologist oncologistdr. ashish udhrain. doctor, welcome to the show.thank you. why exactly does breakthrough cancer painhappen and why does it happen for certain patients and not for others?breakthrough cancer pain is defined as sudden flare or burst or breakthrough of baselinepatient pain that patients experience while

taking pain medications.and why does it happen? cancer pain can happen from chemotherapy causescertain types of pain such as neuropathic or burning pain in your hands and feet. cancer,in and of itself, for example invading into the bone can cause stabbing sharp pains inyour bones. so it can happen for a multitude of reasons for different types of cancers.just being on baseline morphine or oxycodone or what have you does not eliminate that possibility.doctor, i understand that your experience with breakthrough cancer pain is not justclinical. it's actually personal. can you tell us a bit about your story?sure. my mother was diagnosed with metastatic uterine cancer four years ago. the treatmentthat she received caused neuropathic pain

which is the burning, numbness, and tinglingpain. she's had progressive bone pain associated with the disease. she would have these episodesof breakthrough cancer pain which unfortunately just the medicines she was on was not controllingit well. right. and the pain is so intense that itactually breaks through some really powerful drugs like morphine and percocet.yes. right? and this must leave your patients feelingso hopeless. do they even go as far as to open up to their oncologists when this happensto them? patients sometimes don't want to divulge symptomsor side effects to their doctors. why wouldn't they?because they don't want the cancer treatment

to stop. you know, they're afraid that ifthey inform their doctor of too many side effects, that the treatment that may be workingfor their cancer may be stopped because of said side effects. and to others, they feelthat it's just a way of life, that it comes with the whole package of having cancer, thatthis is how they have to survive which is not true.there is good news. you are here to spread awareness and give patients some informationabout a treatment that they might not know about.that's true. there's a class of drugs called transmucosal immediate release fentanyl ortirf. this class of drugs can help eliminate breakthrough cancer pain a lot faster thanwhat immediate release morphine can. they

take as long as 45 minutes for them to takeeffect to work. so what's happening in that time is patients already had their suddenon-set of debilitating breakthrough pain and which may be over. that episode may be overbefore these other products have even a chance to work in their bodies. and the good thingabout tirfs is that the relief of pain can occur as early as 5 minutes.and that's a big deal with you're at your child's soccer game or when you're shoppingor when you're at work. you can't wait 40 minutes when you're feeling the pain at thatmoment. your quality of life, as well as your whatwe call performance status, gets effected. why that's more relevant as also in patientsis because what us as cancer doctors use is

a performance status to see whether or notpatients can tolerate their cancer treatments. so if the patients become too debilitated,they cannot receive their cancer care. are we saying that these drugs are more powerfulthan morphine? fentanyl is about 100 times more potent thanmorphine. this is a reason why the patients who qualify to receive this medication needto be, what we call, opioid tolerant for them to tolerate this fentanyl.and does it come in the form of pills? it comes in multiple different forms. it comesas, what we call, buckle tablet or a tablet that you put in the inside of your mouth.it comes as a buckle film, a lollipop, as well as a spray that you put under your tongue.so, doctor, how significant is this breakthrough

cancer pain treatment for those patients thatare suffering largely in silence? you know, ereka, it's very important becausecancer has a very negative connotation in our society about it being a death sentence.and it's truly not the case because it's truly becoming what we call a chronic disease. andbecause it's becoming a chronic disease, we have to deal with the symptoms associatedwith the disease and/or the consequences from the treatments of the disease. and i tellmy patients, you know, there is an option. i want my patients to live rather than toexist. right.and with this drug class, we can truly get our patients to living their life again ratherthan have to suffer.

i hear you. so they're living, they're present,and they're not living in fear. thank you so much for bringing all of that awareness.i also want you viewers out there to hear how gina's whole outlook changed after receivingthis treatment. yesterday, i started to feel like there wasan episode coming on, so i went to sit in the bathtub so i could relax and so i couldcalm myself down. so i called my elder daughter and i said, "go get me my medicine and setit in the bathroom so that i know that it's there.", and just it being sitting there,i was able to…it just made me feel more confident like i was going to get throughthe situation. now i can enjoy my family more. i can return to my normal life, and i canonly spend a little bit of time on cancer

and pain instead of a lot of time.we have a lot more quality time together now that she can feel better. that makes me happy.and, again, if you are experiencing breakthrough cancer pain, don't suffer in silence. talkto your oncologist. there is also a free book compliments of insys therapeutics. it's agreat resource for both cancer patients and caregivers. all you do is register at breakthroughcancerpain.comto get it. and, of course, you can also logon to accesshealth.tv for more information.(music) access health. (music).according to forbes magazine, only 8% of americans actually achieve the goals they set on january1st. but just because we fail, doesn't mean we don't try. about 40% of americans makenew years resolutions, and just to put that

into perspective about one third of all americanstune in to watch the superbowl. most studies are showing that the goals we set are justtoo big, too unrealistic, and therefore they're too overwhelming. experts say those who doachieve their new years resolutions set smaller more realistic goals. successful goal settersalso stick to specific targets, not a vague one. so, for instance, instead of saying youwant to start working out, commit to a weekly kick boxing or yoga class. and finally, ifyou've already failed at your new years resolution, don't worry. you still have 11 more monthsto succeed. (music). access health.